Information about Military and Civilian Biodefense/Terrorism Countermeasures, vaccines, laws and policies

December 17, 2007

Can troops who refused anthrax shots seek redress?

Time will tell whether military corrects records of troops who rejected orders

By William H. McMichael - bmcmichael@militarytimes.com

When a federal judge ruled in 2004 that the Pentagon’s mandatory anthrax vaccine inoculation program in effect at the time essentially was illegal, it may have opened the door for everyone who had been punished for refusing the shots to get their military records corrected.

That doesn’t appear to be the case quite yet, even though Judge Emmet Sullivan of the U.S. District Court for the District of Columbia reaffirmed his ruling in August in a written opinion on a technicality in the same case.

It is not known if the Defense Department has a stance on whether service members punished for refusing the shots can seek correction of their records; by press time, defense officials did not respond to a Military Times query submitted three days earlier. But the Pentagon continues to argue, according to that August brief, that its 1998-2004 mandatory anthrax vaccine inoculation program was “reasonable.”

The Pentagon also could not provide a precise number of service members who had refused the shots and been punished, or whether any who had been imprisoned are still in jail.

The Air Force said a total of 180 airmen had been punished from 1998 through Dec. 6, with a peak of 62 cases in 1999. Seven of the 180 cases were adjudicated at court-martial. Federal court records from 2000 state that two years after the program began, nearly 500 troops had refused the shots and more than 100 had been court-martialed.

Attorneys who specialize in military law encourage those who feel wronged to seek redress individually, but they also say it may be premature to expect the military to forgive, in broad fashion, what it considered to be serious violations of good order and discipline.

“I don’t think we’re at the point, from a policy perspective, where they would be willing to admit that everyone affected, from a disciplinary level, was wronged,” said Mark Zaid, a Washington attorney who helped represent a group of six former service members who refused to take the shots and filed the suit on which Sullivan ultimately ruled.

And, the attorneys say, military courts apparently do not concur with Sullivan’s ruling.

“The military courts, over and over, have proved themselves absolutely incapable of ruling on this” because it places them in the position of opposing Defense Department policy, said John Michels, a Chicago attorney and former Air Force lawyer who also helped represent the group of plaintiffs before Sullivan.

Michels pointed to a September 2006 decision by the U.S. Court of Appeals for the Armed Forces in the case of Spc. Andrew Kisala, who was court-martialed for disobeying a lawful order to take the anthrax shots in August 2000. The high court ruled that Kisala failed to prove the order was unlawful.

But “you can disobey an unlawful order,” Zaid said — and because Sullivan “ruled that the vaccine was experimental, it was unlawful to administer without consent.”

Lack of access to health records and documentation makes it impossible to estimate with any certainty the number of troops who have complained of adverse reactions without extrapolating from the spotty data publicly available.

According to the Centers for Disease Control and Prevention, and the Food and Drug Administration, between January 1990 and August 2000, 1,544 reports of adverse reactions were logged in their reporting system. During that time, nearly 1.9 million doses of vaccine were given to 463,000 people. Adverse reactions range from skin rashes, headaches and short-term memory loss to blackouts and hemorrhaging.

Defense officials acknowledge that like any vaccine, a reaction to the anthrax shots can occur in up to 35 percent of people, but they say these “typically resolve within 48 hours.” The Pentagon considers the vaccine “safe and effective.”

However, Sullivan found on behalf of the six unnamed plaintiffs in 2004 that the FDA had not properly certified the vaccine as effective protection against airborne anthrax spores, considered the primary threat to U.S. troops. In a December 2003 opinion issued with a preliminary injunction that temporarily halted the military’s mandatory program, Sullivan wrote: “The United States cannot demand members of the armed forces also serve as guinea pigs for experimental drugs.”

The Pentagon subsequently suspended its mandatory vaccine program and made it voluntary until February 2007, more than a year after the FDA affirmed its earlier finding that the vaccine was safe and effective against airborne anthrax. At that time, the shots again became required for all troops deploying for more than 15 days to the Middle East or South Korea.

Decisions such as in the Kisala case, Michels said, don’t generally bode well for troops seeking a reversal of their punishments.

The place to seek redress, said Eugene Fidell, a Washington attorney and military law expert, are each service’s Board for Correction of Military Records or Discharge Review Board.

There is a three-year time limit for filing a case before a records correction board, although that can be waived “in the interest of justice.” Discharge Review Boards allow 15 years for claims.

“We have tried it, and there have been some quiet successes,” Zaid said.

But Massachusetts attorney Dale Saran said he thinks the system is stacked against the troops.

“The board will generally solicit an opinion from a service’s judge advocate general” and be heavily influenced by the government stance, said Saran, who is trying to clear the record of Air Force Lt. Col. Tom Rempfer, one of the first officers to refuse the shots and fight through legal channels.

“My hope is that we can prevail in Tom’s case,” Saran said, “and that will become precedent for future records cases.”

HHS Secretary Leavitt Announces Members of the National Biodefense Science Board

http://www.hhs.gov/news/press/2007pres/12/pr20071217a.html

HHS Secretary Mike Leavitt today announced the members of the National Biodefense Science Board (NBSB). The NBSB will provide expert advice and guidance to the Secretary on scientific, technical and other matters of special interest to the department regarding activities to prevent, prepare for and respond to adverse health effects of public health emergencies resulting from current and future chemical, biological, nuclear and radiological agents.

"This board will play an important role in ensuring that our nation is well-prepared to prevent and respond to public health emergencies," Secretary Leavitt said. "The members' depth of expertise will be invaluable as we continue to prepare."

Authorized by the Pandemic and All-Hazards Preparedness Act, the board is holding its first meeting today and tomorrow in Washington. Members of the National Biodefense Science Board are:

Patricia Quinlisk, M.D., M.P.H., ChairDr. Quinlisk is the medical director and state epidemiologist for the Iowa Department of Public Health. She trained as an epidemic intelligence service officer at HHS' Centers for Disease Control and Prevention (CDC), and has served on national policymaking committees and boards dealing with issues of infectious disease epidemiology, biologic emergencies, terrorism-related issues and public health response. Dr. Quinlisk is a policy advisor to the Council of State and Territorial Epidemiologists, and its lead consultant on bioterrorism. She is recognized for her extensive experience in public health and terrorism-related issues, scientific leadership, and national prominence in the public health arena.

Ruth L. Berkelman, M.D.Dr. Berkelman is Rollins Professor and Director of the Center for Public Health Preparedness and Research at Emory University in Atlanta. Her research is focused on emerging infectious diseases, domestic and global disease surveillance and preparedness. She has previously served in the U.S Public Health Service as an assistant surgeon general in positions that included senior advisor to the director of the CDC and deputy director of the National Center for Infectious Diseases.

Stephen V. Cantrill, M.D.Dr. Cantrill serves as the project director and principal investigator of the Biological, Nuclear, Incendiary, Chemical and Explosives (BNICE) Colorado Weapons of Mass Destruction (WMD) Training Center at Denver Health Medical Center. He is an associate professor in the division of emergency medicine at the University of Colorado School of Medicine. He has lectured nationally and internationally on topics including weapons of mass destruction, disasters and disaster management and has been involved in disaster education for more than two decades. Dr. Cantrill is board certified in the practice of emergency medicine.

Roberta Carlin, M.S., J.D.Ms. Carlin is executive director of the American Association on Health and Disability (AAHD). She has been involved in the disability field for nearly 25 years, working in the areas of primary prevention, health promotion and wellness for people with disabilities, government relations, grassroots advocacy and expanding partnerships and collaborative opportunities in the disability field.

Albert J. Di RienzoMr. Di Rienzo is senior vice president and chief science and technology officer for Welch Allyn. Mr. Di Rienzo leads the company's worldwide research and innovation activities, oversees next generation science and technology investigations, and is responsible for growing product development globally. For the past 23 years, his research and development appointments at Welch Allyn, Philips Medical Systems, Siemens Medical Systems, Honeywell/Sperry Aerospace, and General Dynamics Land System have contributed to the advancement of commercial, military, and medical applications.

Kenneth L. Dretchen, Ph.D.Dr. Dretchen currently serves as professor and chairman of the Department of Pharmacology and is director of Georgetown University's Biosecurity Institute. He is a consultant to Department of Homeland Security. For more than 20 years, Dr. Dretchen focused on pharmacological defense from threats by biological or chemical agents. He has evaluated long-term, low-level exposure to nerve agents for possible association with Gulf War syndrome and evaluated several antidotes to nerve agents. He was a member of the team that developed the antidote kit now carried by the United States armed forces. His current research focuses on developing a stand-alone detection system for airborne biological or chemical agents.

John D. Grabenstein, R.Ph., Ph.D.Dr. Grabenstein leads scientific programs for the Merck & Co Inc. vaccine enterprise, including new product planning, adult immunization programs, and scientific outreach. Previously, as a colonel in the U.S. Army, he directed the Military Vaccine Agency at the U.S. Army Surgeon General's Office, supporting over nine million troops, retirees, and their family members dispersed on four continents and dozens of ships at sea. He is the principal author of "Pharmacy-Based Immunization Delivery," a CDC-recognized 20-hour curriculum coordinated by American Pharmacists Association.

James J. James, Brigadier General (Retired), M.D., Dr.PH., M.H.A.Dr. James is director of the American Medical Association (AMA) Center for Public Health Preparedness and Disaster Response, and editor-in-chief of Disaster Medicine and Public Health Preparedness, an official publication of the AMA. James served 26 years with the U.S. Army Medical Department in several capacities including as commanding general of William Beaumont Army Medical Center in El Paso, Texas. Upon retirement in 1997, he was awarded the Distinguished Service Medal, the military's highest peacetime honor.

Thomas J. MacVittie, Ph.D.Since 1995, Dr. MacVittie has been a professor of radiation oncology and pathology at the University of Maryland School of Medicine. He has more than 30 years of experience as a radiobiologist in the field of experimental hematology and has published 139 peer-reviewed manuscripts and 43 book chapters or proceedings. He is recognized internationally as an expert on the effects of radiation on the hematopoietic and gastrointestinal systems in large animal models and their treatment, in vivo, with hematopoietic growth factors. He is director of a National Institute for Allergy and Infectious Diseases-sponsored consortium focused on medical countermeasures against radiological threats.

John S. Parker, M.D., Major General (Retired)Dr. Parker is senior vice president, corporate development, at Science Applications International Corporation (SAIC). He is chief scientist for the Biological Threat Reduction Support Group and a member of the SAIC Homeland Security Strategic Coordinating Committee. Prior to SAIC, he was commanding general, U.S. Army Medical Research and Materiel Command, Fort Detrick, Md., responsible for medical research, product development, technology assessment and rapid prototyping, medical logistics management and health facility planning, and medical information management and technology. He has served as special assistant secretary of defense for medical, chemical and biological defense, and was deputy for medical systems, Office of the Assistant Secretary for Acquisition Logistics and Technology.

Andrew T. Pavia, M.D.Dr. Pavia is the George and Esther Gross Professor and Chief of the Division of Pediatric Infectious Diseases at the University of Utah Health Sciences Center and Primary Children's Hospital. His research has focused on HIV and AIDS in the United States and in resource poor settings, influenza, vaccine preventable diseases, emerging infections and food borne diseases. He is the chair of the National and Global Public Health Committee of the Infectious Disease Society of America and has been a consultant to the Utah Department of Health and a member of the Governor's Task Force for Pandemic Influenza. He is on the editorial board of the Journal of Acquired Immune Deficiency Syndrome, a section editor for Current Infectious Disease Report, and a reviewer for numerous journals.

Eric A. Rose, M.D.Dr. Rose is executive vice president for life sciences at MacAndrews & Forbes Holdings and CEO of Siga Technologies, Inc. He is currently on leave as professor and chairman of the Department of Surgery at Columbia University College of Physicians and Surgeons. He pioneered heart transplantation in children, performing the first successful pediatric heart transplant and has investigated alternatives to heart transplantation, including cross-species transplantation and man-made heart pumps.

Patrick J. Scannon, M.D., Ph.D.Dr. Scannon is executive vice president and chief biotechnology officer of Xoma, Ltd. His research interests include therapeutic approaches to infectious diseases, immunology and oncology using monoclonal antibodies and recombinant proteins, as well as rapid response technologies for biodefense medical countermeasures. Dr. Scannon holds, or has held, consulting positions with the Biodefense Network Assessment (Department of Homeland Security); the Defense Science Research Council; NASA Mars Recovery Program; and the Threat Reduction Advisory Committee (Department of Defense) among others. He is the author of 49 scientific articles and currently holds 21 U.S. patents.

December 16, 2007

Finding link to anthrax, professor set NAU apart

One of the world's foremost anthrax researchers toils in a cramped, windowless lab at Northern Arizona University.

Inside a locked room only a few can enter, he and his research team study germs so dangerous that the U.S. government considers them top bioterror threats.

It was here that Professor Paul Keim made a significant discovery: the 2001 anthrax letter attack on a Florida photo editor came from a genetic strain identical to one developed in U.S. government labs. The finding led the FBI to rule out foreign terrorist attacks in the jittery days after Sept. 11. The FBI called the anthrax letters the worst biological attacks in U.S. history.

Keim's anthrax analysis catapulted his career from niche researcher to the equivalent of a scientific rock star and shone a new light on NAU. His grant funding skyrocketed from less than $1 million to about $8 million a year, and his research on more-common diseases expanded.

Soon he will have a new lab to match his world-renowned status.

He and his team of 50 researchers are moving into the top floor of a $25 million three-story, glass-and-brick building billed as one of the most energy-efficient in Arizona. The lab space is more than triple what they have now. The building's most talked-about feature, besides the fact it will house anthrax, is the use of recycled blue jeans to insulate the walls. NAU needed to build the lab because of the increased biodefense research workload and more federal safety and security restrictions since 2001. Keim, 52, has come a long way in six years.

In early 2001, he had 25 researchers for his various projects and was among a handful of U.S. scientists who worked on Bacillus anthracis, the bacterium that lives in soil and causes anthrax disease. The lethal germ is considered a top bioterror threat because even a tiny amount of spores, smaller than the head of a pin, can kill if lodged in the lungs.

Keim was well-known in genomics circles, a scientific field that studies genes and their function. In the late 1990s, he and a colleague, Paul Jackson, pioneered a DNA fingerprinting technique to distinguish among the various anthrax strains. The finding revolutionized anthrax research but stopped short of elevating him to the ranks of famous scientists who transcend their fields.

Everything changed six years ago when doctors diagnosed Bob Stevens, a photo editor of the supermarket tabloid the Sun, with anthrax.

Fateful call

On the afternoon of Oct. 4, 2001, Keim was in his office when the telephone rang. On the other end was an FBI agent, who told him a plane was on its way to Flagstaff from Atlanta with a culture taken from Stevens' spinal fluid. The FBI wanted Keim to analyze the DNA and find out what type of anthrax Stevens had contracted. This could provide possible clues to where the anthrax originated.

Keim broke into a sweat, and his hands tingled.

He had expected the call. The FBI knew his reputation, and his NAU lab had the world's largest database of about 2,000 anthrax strains.

Four hours later, Keim jumped into his 1990 Toyota 4Runner and made the 15-minute drive to Flagstaff's Pulliam Airport. The setting sun painted the sky red as the small FBI plane landed. A door swung down, and a blond woman stepped out with a cardboard box in her hands.

"This is the anthrax," she said.

The plane and the blonde brought to Keim's mind visions of a famous movie and a moment of humor in an otherwise serious situation.

"I'm like Humphrey Bogart in Casablanca," he thought.

The agents filled out paperwork, then handed the box to Keim, who placed it in the back of his 4Runner and drove back to his lab. A glass tube nestled in ice held the culture from Stevens' body. Keim and a couple of his key researchers worked through the night, isolating, processing and magnifying the DNA using machines and computers similar to ones found in crime labs. In the early morning, they compared the results with their anthrax database. They found a match: a virulent type called the Ames strain. The U.S. Army developed the lab strain in the 1980s as a test for the anthrax vaccine.

Keim outlined his results the next morning in a conference call with the FBI and the Centers for Disease Control and Prevention in Atlanta.

The media knew nothing of Keim's analysis. Then a few days later, a Florida U.S. attorney held a news conference on the anthrax investigation and said the FBI had sent samples for analysis to NAU.

Within 90 minutes, television satellite trucks pulled up and news crews tried to push into his lab. University officials posted 24-hour guards and rushed to install extra locked doors. Hundreds of news reporters left messages on his voice mail.

A producer from the Oprah Winfrey Show wanted to have a camera in the lab when Keim discovered who committed the anthrax attacks.

"I knew I had made the big time when Oprah Winfrey called," Keim said.

He gave no interviews, based on advice from the FBI, which worried that revealing details could jeopardize the investigation and could make him a potential target of whoever committed the crimes. He snuck in and out of his lab using various doors to avoid the media and stopped answering his telephone.

He even had a stalker. A woman, convinced she had contracted anthrax, left messages on his voice mail and showed up outside the building. She wanted him to cure her. She called him once from the waiting room of a doctor's office in Prescott, adding "but I still want to see you, Dr. Keim."

Growing reputation

As the FBI investigation progressed, Keim gave limited interviews and confirmed his help to the government. The FBI sent more cultures for analysis. The Los Angeles Times and the Wall Street Journal featured him on their front pages. He spoke before Congress during terrorism hearings.

His sudden fame gave a new prominence to NAU, the smallest of Arizona's state universities and the least research-intensive of the three. In the university world, famous scientists lead to more research grants and enhanced prestige. Star scientists help draw other high-ranking scientists and students.

"As far as the biosciences go, Paul put NAU on the map, and he continues to do so," said David Engelthaler, a former state epidemiologist who has known him for a decade.

Keim stayed down-to-earth with his sudden fame, Engelthaler said. He could talk to top scientists one day and fit in with regular folk at a community event the next day.

Keim's higher profile had an important side benefit for Flagstaff's economy. In addition to his work at NAU, Keim since 2003 has been director of pathogen genomics at the Phoenix-based Translational Genomics Research Institute, or TGen. The non-profit organization opened a new facility, TGen North, in Flagstaff in 2006, and it has grown to employ 14 people.

"In a sense, he's an economic-development agent all by himself," NAU President John Haeger said.

Yet even as his national reputation grew, he and other researchers faced questions.

Investigators speculated that whoever committed the attacks had access to Bacillus anthracis and an intimate knowledge of how the pathogen worked.

Scientists came under scrutiny.

The bacterium that causes anthrax is rare. The average person's chances of coming into contact are slim. Anthrax is far more common in animals, and human cases often come from people handling infected animal hides.

The anthrax-spiked letters, which sickened 22 and killed five Americans, had been "weaponized." Someone had concentrated the bacterial spores to make them easier to inhale and more lethal.

Some mornings, Keim talked to FBI agents about his anthrax analysis. Then in the afternoons, other agents interviewed him about his whereabouts before the attacks. Keim had an alibi. He had been in Arizona, far from the East Coast where the letters were postmarked.

He, like many others, wondered who did it.

One night he woke up as his mind raced through possible suspects. He reported his suspicion to the FBI.

"They evidently investigated this person, and it wasn't him," Keim said. He declines to say whom he suspected.

More than six years after the crime, the FBI has made no arrests.

Research continues

Keim's current lab is in the locked wing of a science building.

"You might as well smile for the camera; they're recording you," Keim tells visitors as they go through several locked doors.

A sign outside the lab that says "Molecular genetics" hints at the important science going on behind closed doors.

Inside, machines hum. Undergraduate students in white lab coats prepare anthrax DNA samples for analysis. Students sit at banks of computers where they read and interpret DNA analysis from the machines.

The number of researchers in Keim's lab has doubled since 2001, and their research into other pathogens has expanded. Keim also has a second lab through TGen North near the Flagstaff airport.

Keim walks through the NAU lab dressed more like a business executive on a semi-casual day than a scientist, in his chocolate blazer and tan slacks and a blue dress shirt.

His schedule is a blur. The previous day he spoke at a biodefense meeting in Boston. On this morning, he gave Arizona legislators a tour of his lab. In two days, he leaves for Thailand, where he has a project with melioidosis, a lethal infectious disease found in Southeast Asia and northern Australia.

Since 2001, his research on other common diseases has expanded. His various projects read like an encyclopedia of illness and disease: valley fever, the staph "superbug," tuberculosis, salmonella, E. coli, plague, sepsis, pneumonia.

One grant is aimed at developing DNA fingerprinting for all bacterial pathogen threats. It's not science for science's sake. Faster identification of life-threatening illnesses means doctors can diagnose and treat patients earlier.

This year, Keim and his research team got a U.S. patent for a new method to identify various strains of the tuberculosis-causing bacterium. He has similar patents pending for salmonella and E. coli. The Centers for Disease Control and Prevention used his technology to track the recent California spinach E. coli outbreaks.

The anthrax attacks created a sort of "war dividend" for public health, Keim said, as scientists use labs and instruments developed for biodefense to also study common diseases.

"The improvements in public health would never have occurred without the 'anthrax letter' attacks," he said.

Reach the reporter at anne. ryman@arizonarepublic.com or at 602-444-8072.

December 13, 2007

Soldiers being trained to give immunizations to base civilians

YONGSAN GARRISON, South Korea — With even more family members on the way to South Korea as part of the transformation of U.S. forces on the peninsula, the 18th Medical Command had some good news for those who will be seeking immunizations.Thanks to a team of instructors from Walter Reed Army Medical Center in Washington, 19 more 18th Medical Command soldiers will be qualified Friday to administer immunizations to civilians.

The instructor team was in South Korea to give a five-day immunology course to medics.

Prior to the course, the medics were qualified to give immunizations only to active-duty soldiers. The five days of training are normally part of Walter Reed’s 5½-week immunization and allergy technician course.

But the cost and loss of manpower involved in sending them on temporary duty for that training would not have been practical, said Master Sgt. Desmond Smith, 18th Medical Command spokesman.

“It’s easier to bring someone here than to send 19 soldiers to the States,” he said.The visiting instructors did not cover the allergy portion of the 5½-week course, so students will not receive what the Army calls an additional skill identifier. They will, however, receive a certificate of completion for their training and a memorandum verifying they have completed the training necessary to give immunizations to children.

“There was clearly a need at 121 [Combat Support Hospital] to increase the number of people who could give pediatric immunizations,” said Maj. Cecilia Mikita, who led the team from Walter Reed.

The training covered 20 types of immunizations and six ways to administer them. It also included lectures on record keeping, the effects of various vaccines on the body, and the proper handling and storage of vaccines.

Included in the hands-on portion of the course were stations at the hospital’s pediatric immunization clinic, 1st Replacement Center’s medical in-processing area, and Yongsan Garrison’s Troop Medical Clinic.

“A lot of stuff I learned on the job, but this course gives you a real standard,” said student Pfc. David Dasilma. “I can educate my patients now and tell them why they need a shot and what it does to their body.”Smith said the training should lead to a decrease in wait times at immunization clinics.

“It helps because if you come in for a shot there’s more than one person available to give it now,” he said.

December 12, 2007

Airman wins anthrax-related lawsuit

By William H. McMichael - bmcmichael@militarytimes.com

The Pentagon is removing a letter of reprimand given three years ago to a former Air Force staff sergeant who complained to a doctor, and later a newspaper, about migraine headaches he thought might be the result of his anthrax vaccinations — then later sued the Defense Department over his freedom to speak out about the controversial program.

In the settlement, dated Nov. 29, the Defense Department said the letter of reprimand is “deemed to be of no effect.”

Former Staff Sgt. Jason Adkins made no claim for damages in his lawsuit, and no payments were made; all he wanted was the letter of reprimand removed from his military records.

Still, the Air Force “tried for three years” to get the case thrown out of court, said Stephen Neuberger, Adkins’ lawyer.

In addition to the complaint that his right to speak out was suppressed, Adkins’ suit also alleged that the Air Force tried to make an example of him to silence dissent in his Dover Air Force Base, Del., squadron.

By some estimates, hundreds of service members were punished for refusing to take the shots from 1998, when the Pentagon initiated its mandatory anthrax vaccine program, through 2004.

In October 2004, Adkins, a C-5 transport aircraft flight engineer who had taken all six anthrax shots, awoke with a migraine. While en route to Dover to see a flight surgeon, as safety protocol dictates, he learned via a cell-phone call that he was on tap for a mission the next morning.

Adkins told the doctor he had been suffering headaches for a “long time” and, having read a recent series of investigative stories about the controversial anthrax vaccine in the local media, said he thought his problems might be related to the shots. The surgeon downplayed that notion, changed Adkins’ flight status to “Duties Not To Include Flying” and prescribed some narcotics.

Adkins called his enlisted boss with the news. Within 3½ hours, he was ordered to report in full dress uniform to his squadron commander, Lt. Col. Christos Vasilas. Afterward, two senior sergeants chewed him out, he said, accusing him of dereliction of duty and faking his malady, and gave him a letter of reprimand and 76 hours of additional duty.

Adkins said he endured nearly eight months of harassment, with leaders threatening to pull his flight wings, not letting him wear his flight uniform and keeping him grounded.

But the harassment also drove him to go public, Adkins said.

He went to the media and started talking. He also filed suit against the Defense Department and former Defense Secretary Donald Rumsfeld, claiming violation of his free speech rights.

Adkins, who now works in a landscaping business in Smyrna, Del., said he’s happy he left. “I just wish they’d stop that anthrax vaccine,” he said. “Nobody wants to say anything because you’re basically ending your career.”

He said he still gets headaches. “Oh, yeah, ... ringing in the ears. It still hasn’t gone away.”

Woman says vaccines led to illness

By Ryan Dostalek, Leader-Telegram staff

When UW-Eau Claire student Nicole Lillis joined the U.S. Army in January 2001, she knew risks were involved. Now, after being out of the service for nearly four years, the effects of her military service still resonate, and the sacrifices she was prepared to make are not the ones she currently battles.

Lillis, 29, an Eau Claire native, suffers from symptoms commonly associated with autoimmune disorders, including constant joint, neck and back pain. She and her doctor at the Madison Veterans Affairs Hospital believe her symptoms are linked to vaccines she took during basic training. Leading researchers in the field also believe there is a connection between vaccines and autoimmune disorders. However, the U.S. government emphatically denies the claims.

Lillis joined the U.S. Army, originally enlisting in the airborne program. She reported to Fort Leonard Wood, Mo., for basic training, where she said she and the other recruits received 12 vaccines, one of which she later found to be an experimental pneumonia vaccine, according to a consent form she found in her medical records.

She said she never saw the form at the time she received the vaccines.

Complications began about two months into training, when she began having extreme pelvis and joint pain. She said she passed the pain off as being a result of the grueling training.

"I remember being so tired and in so much pain, but I just figured that it all had to do with the physical demand of basic training," she said. "So, I just pushed through it."

When Lillis completed basic training, a stress fracture in her pelvis barred her from airborne training. She went into military police training to complement the criminal justice degree she was working on at UW-Eau Claire.

When she returned to UW-Eau Claire in 2006, she changed her major to mass communications. She expects to graduate in 2009.

After she completed basic training and military police training in May 2001, a drill sergeant gave her some advice. "My drill sergeant looked me in the eye and said, 'The Army will never be worth your health,' " she said. "I will never forget that."

After her training at Fort Leonard Wood, the Army stationed her at Fort Hood, Texas, where she worked as a patrol officer and then as a 911 dispatcher. That was where the complications got worse, she said, making note of one night when she went to the bathroom, collapsed and began vomiting continually.

Last summer, she had a similar vomiting spell.

A doctor at Fort Hood diagnosed her with bursitis, which is characterized by painful joint inflammation. Military doctors then later diagnosed her with fibromayalgia in January 2002 - leading to her honorable discharge in May 2003.

When Lillis returned to Wisconsin in January 2006, she went to the VA hospital in Tomah, where she was referred to a doctor at the Madison VA hospital. He diagnosed Lillis as being on the borderline for have lupus, an autoimmune disorder, and she said he told her there was no doubt the "vaccines kicked my immune system into overdrive."

A representative from the Military Vaccine Agency, the Department of Defense body that oversees military vaccine policies, refused to give his name because of department protocol. He said protecting soldier health is the No. 1 priority of the agency and the department and said all vaccines administered are "safe and effective."

"Absolutely all of the vaccines are FDA approved," he said. "There have never been experimental vaccines given to any service members."

Lillis' complaints aren't the first of their kind. A handful of sick soldiers filed a lawsuit, Doe v. Rumsfeld, in which courts favored the soldiers and issued an injunction halting the Anthrax Vaccine Immunization Program, a mandated military program. AVIP started in 1998, and the injunction was served in December of 2003. The Defense Department resumed the program in February of this year.

In 1994, vaccine researcher and immunologist Pamela Asa discovered a link existed between the anthrax vaccine administered to troops and autoimmune disorders, including symptoms of what doctors later called Gulf War Syndrome, according to studies published in 1999 and 2001. The Food and Drug Administration confirmed the study and considered it when issuing the 2003 injunction.

Asa, along with a colleague at Tulane University in New Orleans, discovered the presence of squalene in six lots of anthrax vaccines given to soldiers who began experiencing symptoms associated with autoimmune disorders. Squalene, she said, is an adjuvant, an oil-based chemical added to increase the effectiveness of the vaccine. However, when introduced into the human body, it has negative effects, according to Asa's research.

"I can't put into words the look of horror on (the soldiers') faces and how difficult it was to tell them that the country and the government they were willing to die for had done this to them," Asa said.

"It makes me sick to tell these kids they are positive for anti-squalene antibodies," Asa said, adding that anti-squalene antibodies become present in the body to fight off the squalene.

Lillis is unsure if she received the anthrax vaccine because her vaccination records were not included with her medical files after she was discharged.

Lillis and Asa have been trying to get the government to acknowledge the harmful effects of vaccines on soldiers, but both said they have had little luck.

"I've been fighting this since 1994," Asa said. "And I've been receiving hell for it the entire time."

Despite the government's response, Lillis and Asa said they will continue fighting for acknowledgement and change in the government.

"It's just something that I live with," Lillis said, now six years after the symptoms began. "I don't let it get me down. I'm so stubborn, and I will fight this until the end."

December 11, 2007

Grabenstein never really went away, he just collects two paychecks

Meryl Nass, MD, mnass@gwi.net

It has been my impression that retired pharmacist Col. John Grabenstein, who went to work as a vice president for Merck's Vaccine division in mid 2006, has nonetheless been moonlighting for the anthrax vaccine immunization program, presumably as a consultant to the private companies that were hired to "manage" it. Grabenstein supervised a body of "studies" of anthrax vaccine safety while on active duty that were so badly flawed, even the FDA described their methodologic failings in the vaccine label and failed to use them to assess the vaccine's safety.

Slick Grabenstein never missed a beat. He managed to finesse the 2000-2002 IOM committee into ONLY using that body of research, and deliberately omitting from consideration all the Gulf War studies that showed anthrax vaccine was statistically related to GWS. That is how the committee wound up saying the vaccine was "sufficiently" safe. [i.e., Good enough for government work(ers)]

Now the Grabber is at it again. He picks a retrospective evaluation of physical examinations, which are known to miss the signs and symptoms of both GWS and other anthrax vaccine injuries, to again demonstrate the vaccine is "safe." He is a true master of garbage methodology. (Keep watching as the real side effect profile of Gardasil vaccine slowly trickles out; Grabenstein has responsibility for the bogus PR disseminated regarding that vaccine. IN the case of Gardasil HPV vaccine (Remember the "one less" campaign on TV?) he was building his career on the backs of young girls aged 9 and up, a number of whom died following vaccination, not to mention the miscarriages and other problems.)

Boston University School of Public Health, Boston, MA, USA. jill.downing@ bmc.org

OBJECTIVE: Anthrax in weaponized form is the bioterrorism agent of most concern. Questions raised about the safety of the anthrax vaccine can be addressed by comparing immunized and unimmunized people in population-based studies. METHODS: A retrospective evaluation of data from periodic physical examinations collected on anthrax- immunized and -unimmunized US Army aircrew members between 1998 and 2005 was performed to evaluate the safety of anthrax immunization.

Mean changes in variables found on physical examination and laboratory analysis were compared by use of t tests. Multiple linear regression predicted change in outcome from baseline characteristics. RESULTS: We compared 6,820 immunized subjects and 4,145 unimmunized controls based on US Army aircrew physical examination and screening laboratory tests. No association between anthrax immunization and a clinically relevant change in a tested physiologic parameter was detected. CONCLUSIONS: No attributable risk of anthrax immunization was observed in this group of Army aircrew members.

ALBANY -- A federal judge on Monday dismissed a lawsuit filed against the Department of Veterans Affairs by the widows of five veterans who died after being enrolled in corrupt drug experiments at Stratton VA Medical Center.

In dismissing the case at the request of federal attorneys, U.S. District Court Senior Judge Thomas J. McAvoy cited the fact there is no proof the veterans, all of whom were terminally ill cancer patients, had died prematurely or endured added pain and suffering as a result of being fraudulently enrolled in studies designed to test drugs for marketability.

"Sometimes a court has to render a decision it would not like to render," McAvoy said.

He commented from the bench that what went on at Stratton hospital was "egregious conduct" but he is bound to follow "existing law" which sets no basis for the plaintiffs' families to recover damages in the case.

Alan Milstein, a Philadelphia- area lawyer hired by the widows, argued in court that the widows deserve compensation because their husbands suffered in ways that cannot be measured from forged medical records or the opinions of expert physicians.

Milstein also compared the criminal research violations that went on at Stratton to thousands of cases in which body parts have been stolen from corpses as part of an underground network that traffics human remains for research. In those cases, Milstein said, the victims did not physically suffer but they and their families endured a form of "dignitaryharm," which New York courts do not recognize.

The lawsuits against the VA stemmed from a criminal investigation that found dozens of veterans had been subjected to fraud and deception after their medical records were altered to enroll them in drug studies at Stratton. The government admitted wrongdoing in only one veteran's death because it could be proven in that case that the patient died as a result of receiving experimental drugs, according to court records.

The case involved the death of James J. DiGeorgio, a 71-year-old Air Force veteran from Rensselaer County who died at Stratton in June 2001. Last December, the government paid $500,000 to settle a lawsuit by DiGeorgio's widow.

That settlement left five other widows who pursued a class-action lawsuit, but Monday's ruling effectively ended their case unless they file an appeal.

"When you use individuals, humans, as guinea pigs, you do them harm," Milstein told McAvoy. "What happened at the Stratton VA is a black mark in the history of human subject research. They and their families deserve to be compensated. "

Assistant U.S. Attorney Karen Goodwin, who argued the government's motion, declined comment as she left court.

Two people, including the hospital's former cancer research director, Dr. James A. Holland, pleaded guilty to federal criminal charges in connection with the scandal. Holland is scheduled to be sentenced next month for his guilty plea to a misdemeanor count of not keeping proper medical records.

A former Stratton research coordinator, Paul H. Kornak, is serving a 71-month prison term in Ohio for negligent homicide and other felony charges.

"A great wrong was committed here," Milstein said in court. "The question for this court is whether the law will recognize it. ...They committed every kind of research ethics violation imaginable."

The government argued that while the veterans were fraudulently enrolled in drug studies, some of them may have benefitted from the treatments and may have lived months longer than expected. The government's attorneys also said there is no proof the men wouldn't havedied if they received standard chemotherapy treatments rather than experimental regimens.

Jayne Steubing, whose husband, Carl, died at Stratton VA after being given a breast cancer drug to treat esophageal cancer, was the only widow in court for Monday's hearing. Steubing and her stepson, Kurt, issued the following statement to the Times Union late Monday:

"We are disappointed in the judicial process and in the judgment itself, as neither brought closure for the families in this case. The fact that the judge himself admitted how painful it was for him to render this decision made it all the more difficult to accept."

Carl Steubing's medical records were altered without his knowledge to qualify him for a drug experiment run by Kornak and Holland, according to court records.

Both Kornak and Holland were fired from Stratton in late 2002, almost a year after the first instance of fraud was discovered by a monitor for a Texas drug company funding one of the studies. Holland blamed Kornak for the scandal, while Kornak has said he was only following orders and that hospital officials knew what was taking place.

Investigators discovered that Kornak, who did not finish medical school, had been posing as a medical doctor when it was widely suspected by hospital staffers -- and reported to Holland -- that Kornak was not a physician.

Holland, who has admitted allowing unqualified workers to handle his medical duties, alleged Kornak sought to earn extra overtime pay by enrolling as many patients as possible in the research studies.

Kornak and at least one other research coordinator gave sworn depositions earlier this year in which they said Holland had pressured them to enroll patients in drug studies because their salaries and job security was at stake.

Steubing was a World War II veteran who enlisted in the Army in 1942 and served for three years, and fought in the Battle of the Bulge. He was awarded the Bronze Star for bravery after leading his platoon to safety when their commanding officer was shot and a Purple Heart for injuries sustained in combat.

Human research studies at dozens of Veterans Affairs hospitals underwent a review as a result of the scandal at Stratton. National hiring reforms also were put in place at VA hospitals after it was uncovered that a VA oncologist had hired Kornak despite the fact he had a criminal record for trying to illegally obtain a medical license.

December 4, 2007

State Commission Looking Into Non-Combat Soldier Deaths

AUGUSTA (NEWS CENTER) -- A special commission set up after the death of National Guardsman Pat Damon is looking for families to share their stories about loved ones who have suffered non combat deaths or disabiltiies.

The commission to protect the lives and health of members of the maine national guard met Tuesday in Augusta, but the weather kept a lot of people away.

The commission's goal is to prevent future non-combat deaths and injuries by learning from the past and seeing to it that a better job is done protecting soldiers in the future.

To this day, the cause of Patrick Damon's death remains in question. His mother is convinced her son's body finally rebelled against all the vaccinations he had been given in a short amount of time.

December 3, 2007

Selling the threat of bioterrorism

A scientist defected, warned of epidemics, helped shape policy and sought to profit.By David Willman, Los Angeles Times Staff Writer

WASHINGTON -- In the fall of 1992, Kanatjan Alibekov defected from Russia to the United States, bringing detailed, and chilling, descriptions of his role in making biological weapons for the former Soviet Union.

As a doctor of microbiology, a physician and a colonel in the Red Army, he helped lead the Soviet effort. He told U.S. intelligence agencies that the Soviets had devoted at least 30,000 scientists, working at dozens of sites, to develop bioweapons, despite a 1972 international ban on such work.

He said that emigrating Russian scientists and others posed imminent threats. After the breakup of the Soviet Union, he said, several specialists went to Iraq and North Korea. Both countries, he said, may have obtained anthrax and smallpox. The transfer of smallpox would be especially ominous because the Russians, he said, had sought to genetically modify the virus, posing lethal risk even to those who had been vaccinated.

His expertise, combined with his dire pronouncements, solidified his cachet in Washington. He simplified his name to Ken Alibek, became a familiar figure on Capitol Hill, and emerged as one of the most important voices in U.S. decisions to spend billions of dollars to counter anthrax, smallpox and other potential bioterrorism agents.

"It was Alibek's revelations, when he defected, that really provided the first information about the scope" of both the Soviet program and the possible proliferation to Iran and Iraq, said Dr. Thomas Monath, who was a top biodefense specialist for the U.S. Army.

Monath, who later led a group of experts that advised the Central Intelligence Agency on ways to counter biological attacks, said Alibek's information resonated at high levels of the U.S. government and was "amplified by 9/11."

"I think he influenced many people who were in position to make some decisions about response," Monath said, adding, "Concern about smallpox, in particular, was driven by Alibek."

Dr. Kenneth W. Bernard, who served President Bush as a special assistant for biodefense, agreed, saying that Alibek "had a substantial and profound effect."

Having raised the prospect that Iraq had acquired the ability to wield smallpox or anthrax, Alibek also was outspoken as the U.S. went to war in early 2003, saying there was "no doubt" that Saddam Hussein had weapons of mass destruction.

Officials still value his seminal depictions of the Soviet program. But recent events have propelled questions about Alibek's reliability:

No biological weapon of mass destruction has been found in Iraq. His most sensational research findings, with U.S. colleagues, have not withstood peer review by scientific specialists. His promotion of nonprescription pills -- sold in his name over the Internet and claiming to bolster the immune system -- was ridiculed by some scientists. He resigned as executive director of a Virginia university's biodefense center 10 months ago while facing internal strife over his stewardship.

And, as Alibek raised fear of bioterrorism in the United States, he also has sought to profit from that fear.

By his count, Alibek has won about $28 million in federal grants or contracts for himself or entities that hired him.

He has had well-placed help. Some of the money has been allocated because of a Southern California congressman's "earmarks," controversial budget maneuvers that direct federal agencies' spending. Moreover, two senior aides to a New Jersey congressman who also provided crucial help to Alibek left government and promptly joined his commercial efforts.

Alibek now is seeking new government contracts related to countering biological terrorism that could be worth tens of millions of dollars.

He has followed an unconventional scientific approach, seeking a product that would protect against an array of deadly viruses and bacteria, not just a single germ.

He also is raising money to build a drug-manufacturing plant in the former Soviet republic of Ukraine. From there, his company will seek to sell its antiviral agents and antibiotics to the U.S. government's Strategic National Stockpile, he said.

Thickly built and with willing, if imperfect, English, Alibek said in an interview that his focus had been scientific, "in terms of raising awareness about biological weapons and biological terrorism." An attack, he said, could kill "hundreds of millions, if not billions" of people.

The Los Angeles Times explored Alibek's public pronouncements, research and business activities as part of a series that will examine companies and government officials central to the U.S. war on terrorism.

Uncertainty surrounds the threat of a biological attack. Authorities list no fewer than 30 fungi, bacteria and viruses as potential biological weapons. One agent, anthrax, already has been deployed in the U.S., killing five people in late 2001. Because anthrax spores can be dispersed in a variety of ways -- perhaps even by bomb -- some experts believe that a well-executed attack could kill millions of people over large areas. Others, citing the vagaries of weather, say that anthrax or other airborne agents are unlikely mass killers.

Some experts question Alibek's characterizations of the threats.

Dr. Philip K. Russell, a retired Army major general and physician who joined the Bush administration from 2001 to 2004 to confront the perceived threat of smallpox, said he was convinced that Alibek had solid firsthand information about the former Soviet Union's production of anthrax. But regarding other threats, such as genetically engineered smallpox, Russell said he "began to think that Ken was more fanciful than precise in some of his recollections."

"He would claim that certain things had been done, and then when you came right down to it, he didn't have direct knowledge of it -- he'd heard it from somebody. For example, the issue of putting Ebola genes into smallpox virus. That was viewed, at least in many of our minds, as somewhat fanciful. And probably not true."

Alibek told The Times that the comments in question were based on articles he read in Russia's "scientific literature."

--

Big transition

Alibek, 56, is now a player in the multibillion-dollar business that has sprouted around the U.S. war on terrorism.

It's been a stark transformation for the former Communist military man.

Alibek grew up in Almaty, the capital of the then-Kazakh Soviet Socialist Republic. After entering the Tomsk Medical Institute in Siberia, he studied the 1942-43 battle of Stalingrad.

As he described in a 1999 memoir, "Biohazard," Alibek concluded that the Soviets had waged biological warfare against the Germans and that "large numbers" of the invaders fell ill with tularemia, a deadly infectious disease also known as rabbit fever.

But Alibek also described a lesson he learned about the risk of waging germ warfare: Because of a wind shift, the Soviets had inadvertently infected their own troops and civilians, causing perhaps thousands of casualties.

When Alibek emerged with a medical degree, he was recruited by the Soviet government and climbed in military rank while earning a doctorate in microbiology. In 1987, he was promoted to a top position in Biopreparat, the civilian agency that ran the Soviets' secret biological-weapons program.

Alibek has said he worked with numerous lethal agents -- including Marburg virus, plague, smallpox and a virulent "battle strain" of anthrax. The Soviets assumed that the U.S., which began developing germ weapons during World War II, maintained its program despite the 1972 international ban.

By the late 1980s, with the Cold War ending, teams of U.S. and Soviet biological warfare experts prepared to visit each other's laboratories to see for themselves.

On Dec. 11, 1991, Alibek and his Soviet colleagues traveled to Ft. Detrick, Md., home to the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), where researchers studied how to protect troops from germ warfare, work that was allowed under the 1972 agreement. And Alibek began making personal connections that would soon ease his transition to American life.

None would prove more important to him than his rapport with USAMRIID director Charles L. Bailey, an entomologist and U.S. Army colonel.

Within a year, Alibek resigned from Biopreparat and fled to the U.S. with his wife and three children. Bailey retired from the Army but stayed at Ft. Detrick as an analyst with the U.S. Defense Intelligence Agency.

Bailey's job was to assess what the Russians were up to.

This gave him a close view of Alibek's confidential debriefings with U.S. intelligence agents. The debriefings, Bailey said, provided "very valuable" information about the Russian program. Alibek described threats beyond the Russian borders.

"Alibek thought that every country that had anthrax" also had smallpox, including Iraq, Iran and North Korea, Bailey said.

In the mid-1990s, when Bailey went to work for a Huntsville, Ala., company with defense and intelligence contracts, Alibek visited frequently. They shared meals, attended horse shows. Alibek seemed to enjoy learning about American life.

"He was easy to like," Bailey recalled. "We became friends."

They also became a commercially sought-after team.

"I helped to build Alibek's reputation with the military," Bailey said. "A lot of people were impressed with Alibek. I was impressed."

The Alabama company also hired Alibek as a consultant, and asked him to compose a history of the Soviet program that could be used by the intelligence community.

In 1997, the two worked together for Battelle, a large nonprofit research and development organization. Next, they moved to Virginia-based Hadron Inc., another firm that had ties to U.S. intelligence agencies. Alibek also circulated among government officials. He privately briefed Gen. Joseph W. Ralston, then vice chairman of the Joints Chiefs of Staff, the nation's second-highest military officer.

Alibek made his first network-television news appearance in February 1998, and three months later testified at a congressional committee hearing on terrorism and intelligence. A news release said Alibek would "provide new information on Russia's offensive biological weapons program."

The only contact listed was a committee staffer named Vaughn Forrest, a onetime candidate for Congress. Forrest in the 1980s had traveled to Afghanistan to support the Muslims who ultimately drove out the invading Soviet Union. In helping Afghanistan's mujahedin, Forrest had developed a productive relationship with the CIA. Forrest introduced Alibek to the chairman of the Senate-House Joint Economic Committee. Forrest took the lead in arranging the hearing.

He and Alibek formed a lasting bond.

In his 1999 memoir, Alibek said that Forrest "was among the first to perceive the potential" for developing a product that would guard against not one, but an array of biological agents.

Forrest introduced Alibek to others who could help, including Florida Republican Bill McCollum, then-chairman of the House Intelligence Committee. Forrest had once been McCollum's chief of staff. McCollum, now Florida attorney general, said Alibek "was worried about what the Soviets had made and what somebody else could get ahold of."

The list of identified suspects, McCollum said, included Libya, Iran and Iraq.

"I thought we had a real threat from this," McCollum said, adding that he distributed Alibek's book to "people in the administration and also members of Congress."

When Forrest left the congressional payroll, he became a consultant to Hadron Inc., where Alibek and Bailey worked. Forrest later became a director with Alibek in a successor company. Forrest declined to be interviewed for this report.

Alibek's public profile rose after the Sept. 11 attacks and the mailings of anthrax a month later that killed five people.

Appearing before a House subcommittee on national security in October 2001, Alibek said that earlier "attempts to wipe out Iraq's biological weapons capability were probably not successful." He also told the subcommittee that Russian biological weapons experts had "emigrated to rogue nations such as Iraq." As the U.S.-led war got underway in March 2003, Alibek said during an online discussion hosted by the Washington Post: "There is no doubt in my mind that [Saddam] Hussein has WMD."

Fear that Iraq possessed smallpox was emphasized by the Bush administration leading up to the war. As Congress prepared to vote on whether to authorize war, then-Defense Secretary Donald H. Rumsfeld told the House Armed Services Committee on Sept. 18, 2002, that a smallpox attack by Iraq could kill as many as 1 million Americans and infect an additional 2 million.

Alibek has not retreated from his statements regarding Iraq's possession of smallpox or other biological weapons. He said in an interview that he had "talked to people who actually visited the Iraqi sites. And they said they had no doubt [there] was an offensive biological weapons program.... We need to look for the traces."

It is a lonely position today.

"There's been a lot of people thrashing around there for the last five years," said Russell, the retired general. "I don't think anybody could have hid it."

Millions in funding

Alibek's most reliable benefactor in Washington has been Rep. H. James Saxton (R-N.J.), a gravelly voiced former elementary school teacher and state legislator. Saxton says that for two decades, he has focused on the threat posed by Islamic terrorism.

For most of the last decade, Saxton chaired the House Armed Services Committee's terrorism subcommittee and also headed the Joint Economic Committee, where Forrest landed as a senior aide.

On May 21, 2002, Saxton called a news conference to announce "a potential new defense against bioterrorism," based on Alibek's tests with mice. After being treated with an experimental product, the mice had survived doses of smallpox and anthrax.

Saxton at the time said that the results held hope for "lifting some of the burden of fear that haunts Americans."

And, while fighting for an earmark of federal grant money for Alibek at a March 2004 hearing, Saxton upbraided Anthony Tether, the Bush administration's director of the Defense Advanced Research Projects Agency.

"You need to be more on his side," Saxton said of Alibek, adding: "I find it hard to believe that I have to fight as hard as I can to get a few measly bucks to keep him going."

Tether assured Saxton that he would accede to his wishes. Tether did so -- and fresh grant money was sent for Alibek's research.

Tether said that he had resisted spending more on Alibek's research because his "cocktail approach" -- mixing more than one drug with other ingredients in search of a product that might protect against smallpox, anthrax and plague -- made it "very hard to determine what is working and what is not."

The research could have dragged on for years with the ambiguous results, Tether told The Times.

"After the [March 2004] hearing, I basically said, 'OK, this is it, Alibek. You're either going to get over here and listen ... or you're not going to get a nickel from us,' " Tether said.

He preserved the funding, Tether said, after Alibek agreed privately to change his approach and perform experiments outlined by Tether's staff. Some of Alibek's subsequent work with mice has shown promise, Tether said.

Alibek also has been helped by Mark A. O'Connell, a lobbyist and Republican fundraiser who for a decade served as Saxton's congressional chief of staff. (Campaign contributions in recent years to Saxton from Alibek, Alibek's wife and one of their business partners have totaled $14,450, public records show.)

O'Connell said he began lobbying Congress for Alibek's company in mid-2003, two months after he left Saxton's staff. His congressional salary, O'Connell said, was slightly below a revolving-door threshold that would have barred him from lobbying Saxton or his staff for one year. He confirmed that he had lobbied for the congressional earmarks benefiting Alibek's company.

Saxton acknowledged in an interview that he had done much for Alibek since Forrest brought them together about a decade ago:

He said he introduced Alibek to then-Speaker of the House Newt Gingrich and to other congressional and executive-branch leaders. Among them was Rep. Jerry Lewis (R-Redlands), who from 1999 to 2005 was chairman of the subcommittee that controlled spending for national security projects. Lewis headed the full House Appropriations Committee from 2005 to 2006.

"We were able to convince Jerry Lewis to begin an appropriations stream for him," Saxton said.

Lewis' spokesman, Jim Specht, did not return telephone calls seeking an interview with the congressman. Earmarks generate controversy because they enable some projects to win federal funding based more on political influence than competitive merit. And earmarks can be carried out discreetly, obscuring the identity of the originator.

This year, Saxton said, he has guided Alibek as he seeks an additional $10 million in research funds -- from the U.S. Defense Threat Reduction Agency.

Saxton said that he had helped Alibek solely to bolster national security.

"I was committed to do whatever I could do to help develop an answer to problems posed by bioterrorism," he said.

"And if they had worked for Alibek or not, I would have been just as committed," he added, referring to Forrest and O'Connell.

Alibek's federal research money also has come from the Army Medical Research and Materiel Command, the National Institutes of Health, the Department of Energy and the State Department, according to company and government documents.

The company that Alibek formed and for which Forrest serves as general manager and as a director, AFG Biosolutions Inc., has said that it is developing "a new generation of vaccines" and medicines for anthrax, smallpox, plague and tularemia.

--

Claims in question

Some of the projects Alibek has helped lead were promoted heavily but faltered.

One sensational claim came in a Sept. 11, 2003, news release from Virginia's George Mason University, where Alibek two years earlier arrived on the faculty.

Findings from laboratory research led by Alibek and another professor, the news release said, suggested that smallpox vaccination might increase a person's immunity to HIV, the virus that causes AIDS. The release quoted Alibek saying, "Our outcomes are very encouraging."

They pointed out that George Mason had announced the results even though the Journal of the American Medical Assn. had declined to publish them. Alibek and his colleagues also submitted a paper summarizing the research to another prominent medical journal, the Lancet.

The paper "was rejected after peer review," said Dr. Sabine Kleinert, senior executive editor of the Lancet, in an e-mailed comment.

More than three years later, no published study has replicated the provocative results touted by Alibek and his colleagues at George Mason. Neither Alibek nor his principal collaborator, who had worked at another university, is still pursuing the project.

"This is a theory that, I must say, does not hold up at all, and it does not make any sense from a biologic point of view," said Dr. Donald A. Henderson, a former White House science advisor whose work with the World Health Organization is credited with eradicating smallpox outbreaks globally. "This idea ... was straight off the wall. I would put no credence in it at all."

Alibek said that it was not his decision alone to issue the September 2003 news release. He ascribed others' criticisms to professional jealousies.

Apart from the university or his company, Alibek has used his ties with the government to promote "Dr. Ken Alibek's Immune System Support Formula," nonprescription pills sold over the Internet. Advertisements for the product described Alibek as a biological and medical expert who had "testified before Congressional committees and is a frequent consultant to the U.S. government."

Alibek acknowledged that he did "consulting work" for a dietary supplement company that distributed the product in his name, but said that he was not paid for subsequent sales. However, an aide to the chief executive of the company, Vital Basics Inc., said that Alibek was paid.

More recently, Alibek's warnings of bioterrorist threats echoed in the debate surrounding "Project Bioshield," signed into law by Bush in July 2004. The program, with an initial budget of about $5.6 billion, aims to encourage companies to develop vaccines or other products that could counter a biological or chemical attack.

And, as Alibek has warned Congress that enemies of the U.S. have sought genetically altered biological agents to resist antibiotics or vaccines, he has promoted products that would address those very threats:

In 2004, a San Diego company, Aethlon Medical Inc., signed Alibek to its advisory board and issued a report, co-written by Alibek, which said its product for filtering toxins from blood "could be rapidly deployed even against genetically altered biowarfare agents."

Alibek's report emphasized the availability of federal funds, including from Project Bioshield. Aethlon said that Alibek served without pay on the advisory board but "may be compensated for future consulting work."

Alibek also hopes to tap into Project Bioshield with his own company.

He said that he expected to submit a proposal to sell what could be millions of dollars of medicines to the government for use in the event of a terrorist attack or other emergency. As envisioned by Alibek, his drug facility in the Ukraine would produce generic versions of antiviral agents or antibiotics at a cost "three, four, five times lower" than if they were made in the U.S.

Meanwhile, within the last year an internal controversy flared regarding Alibek's leadership of the National Center for Biodefense and Infectious Diseases, a fledgling graduate program at George Mason. Alibek resigned as a tenured and distinguished professor there last Aug. 31.

University spokeswoman Christine LaPaille confirmed the resignation and said that George Mason was no longer collaborating with Alibek's company on research backed by any of the recent federal grants or contracts. LaPaille declined to comment on the circumstances surrounding Alibek's departure.

Alibek said the college administration had grown displeased with his company's role in sharing grant-funded research. The university, he said, requested that he dismantle or leave AFG Biosolutions. He chose to resign from George Mason.

This spring, Alibek traveled to the Ukrainian city of Kiev to push his plans for the drug-manufacturing plant and for a center for cancer and cardiac care. He did so after making comments, reported by the Russian news agency Interfax, which struck some officials in Washington as inconsistent with his previous dramatic claims:

Since 1992, Alibek has told U.S. intelligence agencies, and later general audiences, that Russia had persisted in developing biological weapons. For instance, in his memoir, "Biohazard," subtitled, "The Chilling True Story of the Largest Covert Biological Weapons Program in the World -- Told From Inside by the Man Who Ran It," Alibek wrote in 1999:

"I am convinced that a large portion of the Soviet Union's offensive program remains viable despite [then-President Boris N.] Yeltsin's ban on research and testing."

And in a September 2000 interview with an online publication sponsored by the U.S. Department of Homeland Security, Alibek said:

"Russia is still retaining its biological weapons capability, specifically at the Ministry of Defense. The Ministry of Defense is maintaining four major research and production sites, which are still active."

But as reported by Interfax, Alibek in November 2005 told a different story in his ancestral hometown of Almaty: As of the early 1990s, Alibek said, the Russians had stopped "all work to develop biological weapons."

The arc of Alibek's statements has not been lost on Bailey, the former USAMRIID chief who remains at George Mason after having been recruited there six years ago by his former friend. Does the inconsistency cause him to reassess Alibek's earlier statements regarding global biological threats?

Bailey answered quietly.

"Definitely, it does."

Selling the threat

After helping to lead the Soviet Union's germ-weapons program, Dr. Ken Alibek defected to the U.S. and began warning about the threat of a mass-casualty biological attack. Alibek also has sought to profit from the fear of such weapons of mass destruction, landing federal contracts or grants for himself or entities that hired him totaling about $28 million, including several listed below.

Pronouncements

1992: Alibek begins describing to the Central Intelligence Agency details of the biological weapons that he helped research and develop for the then-newly dissolved Soviet Union. The alleged magnitude of the program stuns U.S. officials.

May 1998: Alibek tells a congressional committee that the Russians had produced "hundreds of tons of anthrax weapons" and "tons of smallpox and plague." And by using genetic engineering, Alibek says, the Russians sought to "develop antibiotic-resistant'' strains of various viruses. Alibek also raises the possibility that Soviet weapons scientists sold their expertise to regimes averse to the U.S., such as Iraq and Iran.

1999: In his memoir, Alibek writes: "I am convinced that a large portion of the Soviet Union's offensive program remains viable despite [then-President Boris N.] Yeltsin's ban on research and testing."

October 2001: Appearing before a House subcommittee just a month after the Sept. 11 attacks, Alibek says some Russian biological weapons experts "have emigrated to rogue nations such as Iraq." He adds that he believes some countries have secret stocks of smallpox, and that "well-funded terrorist groups are capable of purchasing the knowledge" needed to execute a biological attack.

March 2003: As the U.S.-led war in Iraq gets underway, Alibek tells an online forum: "There is no doubt in my mind that [Saddam] Hussein has WMD."

April 2007: Asked in an interview to reconcile his earlier statements with the failure to find smallpox or any other weapon of mass destruction in Iraq, Alibek says: "We need to look for the traces."

--

Funding

July 2001: A company at which Alibek is an executive, Advanced Biosystems, wins a $3.59-million contract from the U.S. Defense Advanced Research Projects Agency.

March 2004: A Republican committee chairman, Rep. H. James Saxton of New Jersey, upbraids the Bush administration's director of the Defense Advanced Research Projects Agency on Alibek's behalf. "You need to be more on his side," Saxton says. The official, Anthony Tether, reassures Saxton, and releases grant money for Alibek's research.

July 2004: Saxton and Rep. Jerry Lewis (R-Redlands) work to insert earmarks in appropriation bills that steer millions of dollars to research led by Alibek at George Mason University and at a Maryland company he co-founded, AFG Biosolutions Inc.

2005-2007: Alibek's company wins more than $1 million in small-business innovation research grants from the National Institutes of Health. One of the company's directors is a former aide to Rep. Saxton, and its Washington lobbyist is Saxton's former chief of staff.

December 2, 2007

Lobbying blocks better anthrax vaccine

http://www.earthtimes.org/articles/show/151949.html

WASHINGTON, Dec. 2 An inferior anthrax vaccine fills the national stockpile because of lobbying, reports say.

When fear of anthrax was at its peak, shortly after the Sept. 11, 2001, terrorist attacks, scientists at the Institute of Medicine called for a vaccine that was effective in 30 days, had few side effects and a long shelf life, the Los Angeles Times reported Sunday.

VaxGen Inc. of San Francisco was preparing just such a vaccine, and even won an $877.5 million contract, but its product never made it into the stockpile because of lobbying by the old vaccine's producer, Emergent BioSolutions Inc. of Rockville, Md., the Times said.

Emergent, which relied on its anthrax vaccine to remain solvent, hired 50 lobbyists, turning the tables quickly on VaxGen. Stricter testing requirements were imposed, and Congress overruled the advice of scientific advisers who recommended the company be paid partially in advance to finalize the vaccine, the newspaper said.

As a result, six years later, the stockpile is filled with hundreds of millions of dollars worth of the Emergent vaccine, the Times reported, and Emergent continues to win new federal contracts.

British firm works on anthrax vaccine

Avecia has become a competitor to supply the U.S. But Emergent BioSolutions hasn't given up.

WASHINGTON -- A British company is now a leading contender in the federal government's search for a better anthrax vaccine.

Avecia Biologics Ltd. has tested its experimental vaccine in animals and humans, and plans to seek a contract to supply the U.S. civilian stockpile.

A formal solicitation to prospective suppliers of a genetically engineered vaccine could come this month, federal health officials said.

Avecia's vaccine appears "to be on track and doing pretty well," said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.

The company has received about $75 million in federal grants.

Meanwhile, the government's current anthrax-vaccine supplier, Emergent BioSolutions Inc., is not standing still. It is seeking approval from the Food and Drug Administration for expanded use of its product. Emergent is trying to show through research trials that its vaccine can provide immunity within six months instead of the current 18 months. The company is also exploring whether administering the vaccine differently would reduce side effects.

The benefits foreseen from a new, genetically engineered product "could be accomplished by using this vaccine smarter," said Dr. Tom Waytes, Emergent's vice president for medical affairs.

Gerald W. Parker, a senior federal health official and bioweapons expert, said the country would be better served by having more than one manufacturer supplying anthrax vaccine.

"We need to not put all of our eggs in one basket," Parker said. "We don't want to be dependent upon one technology, one manufacturer, for this threat."

'A Soldier's Officer'

In a nondescript conference room at Walter Reed Army Medical Center, 1st Lt. Elizabeth Whiteside listened last week as an Army prosecutor outlined the criminal case against her in a preliminary hearing. The charges: attempting suicide and endangering the life of another soldier while serving in Iraq.

Her hands trembled as Maj. Stefan Wolfe, the prosecutor, argued that Whiteside, now a psychiatric outpatient at Walter Reed, should be court-martialed. After seven years of exemplary service, the 25-year-old Army reservist faces the possibility of life in prison if she is tried and convicted.

Military psychiatrists at Walter Reed who examined Whiteside after she recovered from her self-inflicted gunshot wound diagnosed her with a severe mental disorder, possibly triggered by the stresses of a war zone. But Whiteside's superiors considered her mental illness "an excuse" for criminal conduct, according to documents obtained by The Washington Post.

At the hearing, Wolfe, who had already warned Whiteside's lawyer of the risk of using a "psychobabble" defense, pressed a senior psychiatrist at Walter Reed to justify his diagnosis.

"I'm not here to play legal games," Col. George Brandt responded angrily, according to a recording of the hearing. "I am here out of the genuine concern for a human being that's breaking and that is broken. She has a severe and significant illness. Let's treat her as a human being, for Christ's sake!"

In recent months, prodded by outrage over poor conditions at Walter Reed, the Army has made a highly publicized effort to improve treatment of Iraq veterans and change a culture that stigmatizes mental illness. The Pentagon has allocated hundreds of millions of dollars to new research and to care for soldiers with post-traumatic stress disorder, and on Friday it announced that it had opened a new center for psychological health in Rosslyn.

But outside the Pentagon, the military still largely deals with mental health issues in an ad hoc way, often relying on the judgment of combat-hardened commanders whose understanding of mental illness is vague or misinformed. The stigma around psychological wounds can still be seen in the smallest of Army policies. While family members of soldiers recovering at Walter Reed from physical injuries are provided free lodging and a per diem to care for their loved ones, families of psychiatric outpatients usually have to pay their own way.

"It's a disgrace," said Tom Whiteside, a former Marine and retired federal law enforcement officer who lost his free housing after his daughter's physical wounds had healed enough that she could be moved to the psychiatric ward. A charity organization, the Yellow Ribbon Fund, provides him with an apartment near Walter Reed so he can be near his daughter.

Under military law, soldiers who attempt suicide can be prosecuted under the theory that it affects the order and discipline of a unit and brings discredit to the armed forces. In reality, criminal charges are extremely rare unless there is evidence that the attempt was an effort to avoid service or that it endangered others.

At one point, Elizabeth Whiteside almost accepted the Army's offer to resign in lieu of court-martial. But it meant she would have to explain for the rest of her life why she was not given an honorable discharge. Her attorney also believed that she would have been left without the medical care and benefits she needed.

No decision has yet been made on whether Whiteside's case will proceed to court-martial. The commander of the U.S. Army Military District of Washington, Maj. Gen. Richard J. Rowe Jr., who has jurisdiction over the case, "must determine whether there is sufficient evidence to support the charges against Lieutenant Whiteside and recommend how to dispose of the charges," said his spokesman.

'A Soldier's Officer'

--------------------------------------------------------------------------------A valedictorian at James Madison High School in Vienna, a wrestler and varsity soccer player, Whiteside followed in her father's footsteps by joining the military. She enlisted in the Army Reserve in 2001 and later joined ROTC while studying economics at the University of Virginia. During her time in college, Whiteside said, she experienced periods of depression, but she graduated and was commissioned an officer in the Army Reserve.

In 2005, she received her first assignment as an officer -- at Walter Reed. As an executive officer of a support company, she supervised 150 soldiers and officers, and her evaluations from that time presaged the high marks she would receive most of her career.

"This superior officer is in the top 10 percent of Officers I have worked with in my 16 years of military service," wrote her rater, Capt. Joel Grant. She "must be promoted immediately, ahead of all peers."

Maj. Sandra Hersh, her senior rater, added: "She's a Soldier's Officer. . . . She is able to get the best from Soldiers and make it look easy."

Seeing so many casualties at Walter Reed made Whiteside feel she was not bearing her full responsibility, she said, so she volunteered for Iraq. When she left in the fall of 2006, she carried with her a gift from her father -- the double-bladed buck knife he had used in Vietnam.

Whiteside was assigned as a platoon leader in the 329th Medical Company (Ground Ambulance) at the Camp Cropper detainee prison near Baghdad International Airport. The hot light from the Abu Ghraib abuse scandal still charged the atmosphere at Cropper, which housed 4,000 detainees and included high-security prisoners such as Saddam Hussein and Ali Hassan Majeed, known as "Chemical Ali," as well as suspected terrorists and insurgents.

Whiteside, given the radio handle "Trauma Mama," supervised nine medics who worked the night shift at the prison. She was in charge of dispatching drivers, medics and support staff to transport sick and wounded Iraqis and U.S. troops around the prison and to a small hospital inside.

"I loved our mission," Whiteside said, "because it represented the best of America: taking care of the enemy, regardless of what they are doing to us."

The hours were brutal. Whiteside ate one meal a day, slept in two four-hour shifts and worked seven days a week. Her superiors credited her with her unit's success. "She has produced outstanding results in one of the most demanding and challenging Combat Zones," her commander, Lt. Col. Darlene McCurdy, wrote in her evaluation.

But the dynamics outside her unit were rockier. From the beginning, Whiteside and some of her female soldiers had conflicts with one of the company's male officers. They believed he hindered female promotions and undercut Whiteside's authority with her soldiers, according to Army investigative documents.

As the tensions with the officer increased, Whiteside said, she began suffering panic attacks. She stopped sleeping, she said, and started self-medicating with NyQuil and Benadryl, but decided against seeking help from the mental health clinic because she feared that the Army would send her home, as it had recently done with a colonel.

On Dec. 30, U.S. military officials took Hussein from his cell at Camp Cropper for execution. The next day, the prison erupted. Thousands of inmates rioted, and military police used rubber bullets, flash-bang grenades and tear gas to restore order.

Whiteside took charge in the chaos, according to written statements by troops in her unit. She dispatched a pair of medics to each compound to begin triage, handed out gas masks and organized her unit to smuggle the prison's doctors out in an ambulance.

The next day, weary from the riots, Whiteside ran into the problem officer. They had another argument.

Army investigative documents describe what happened next.

At 6:20 p.m. a soldier frantically approached Maj. Ana Luisa Ramirez, a mental health nurse at the prison, and said Whiteside was "freaking out" and wanted to see Ramirez. The nurse found Whiteside sitting on her bed, mumbling and visibly upset. Ramirez left to get some medication.

Later, she spotted Whiteside in the darkened hallway with her sweatshirt hood pulled over her head and her hands in her pockets. Ramirez asked Whiteside to come into her room and noticed what appeared to be dried blood on her neck and hands. When she tried to take a closer look, Ramirez said, Whiteside pointed her sidearm, an M9 pistol, at her and "told me to move away and she locked the door," according to a statement Ramirez gave to the Army.

Ramirez tried to take Whiteside's gun, but Whiteside pushed her away and expressed her hatred of the officer she thought was sabotaging her. She grew more agitated and twice fired into the ceiling.

Nurses in the hallway began yelling, and Whiteside shouted that she wanted to kill them, the report said. She opened the door and saw armed soldiers in battle gear coming her way. Slamming the door, she discharged the weapon once into her stomach.

Whiteside says she has little recollection of the events of that night. "I remember bits and pieces," she said. She declined to comment on whether she was trying to kill herself.

The medics who responded to the shooting scene were Whiteside's own crew.

Whiteside was still unconscious when she arrived at Walter Reed a few days later. The bullet had ripped through one of her lungs, her liver, her spleen and several other organs. Her parents and siblings kept a round-the-clock bedside vigil, and her condition gradually improved. Within two weeks an Army criminal investigator showed up in her hospital room, but a doctor shooed him away.

After a month, Whiteside was moved to Ward 54, the hospital's lockdown psychiatric unit, where she was diagnosed with a severe major depressive disorder and a personality disorder. According to a statement by an Army psychiatrist, she was suffering from a disassociation with reality.

Tom Whiteside visited his daughter every afternoon, bringing pizza or Chinese takeout. He often noticed from the sign-in sheet that he was the only visitor on the ward. The psych patients formed a close bond and shared an overriding fear: that the Army would drum them out with no benefits.

One soldier Whiteside befriended was a 20-year-old private named Sammantha Owen-Ewing. Intelligent and funny, Owen-Ewing was training to be a nurse when she suffered mental problems and was admitted to Ward 54. She was still receiving psychiatric care at Walter Reed when the Army abruptly discharged her. According to her husband, she was dropped off at a nearby hotel with a plane ticket.

While on Ward 54, Whiteside received a package from her crew in Iraq. Inside was a silver charm, inscribed with the crew members' names and the message: "Know that you are always loved by us. Never be forgotten and dearly missed. Your Trauma Team." The crew also wore "Trauma Mama" bracelets in solidarity.

After being released from Ward 54, Whiteside joined the outpatient ranks just as the Army was scrambling to overhaul its system for treating wounded soldiers and President Bush ordered a commission to study military care for Iraq veterans.

At Walter Reed, the Army brought in combat-experienced officers to replace the recovering patients whom it had asked to manage the lives of the 700 outpatients on post. The new Warrior Transition Brigade and its more experienced leaders were supposed to manage more adeptly the tension between soldiering and patient recovery.

It was Whiteside's commanders in this unit, a captain and a colonel, who drew up criminal charges against her in April. The accusations included assault on a superior commissioned officer, aggravated assault, kidnapping, reckless endangerment, wrongful discharge of a firearm, communication of a threat and two attempts of intentional self-injury without intent to avoid service.

The Army ordered Whiteside to undergo a sanity board evaluation to determine her state of mind at the time of the shooting.

Tom Whiteside said the criminal charges threatened to unglue his daughter's already tenuous grip on recovery. "If they are doing this to her, what are they doing to those young PFCs without parents by their side?" he asked.

By early August, Elizabeth Whiteside sought an alternative to court-martial. She requested permission to resign, a measure the military often accepts.

Rowe, commander of the U.S. Army Military District of Washington, which has jurisdiction over her case, would decide whether to grant her request.

He reviewed recommendations from Whiteside's two commanders at Walter Reed and the facility's commander, Maj. Gen. Eric B. Schoomaker, a physician. Whiteside's immediate commander at the hospital, a captain, recommended that she be given an "other than honorable" discharge, according to a document obtained by The Post. The captain wrote that her "defense that she suffers from a mental disease excusing her actions is just that . . . an excuse; an excuse to distract from choices and decisions made by 1LT Whiteside."

Col. Terrence J. McKenrick, commander of the Warrior Transition Brigade, agreed: "Although the sanity board determined that at the time of the misconduct she had a severe mental disease or defect, she knowingly assaulted and threatened others and injured herself."

Schoomaker, now the Army's surgeon general, dissented. "This officer has a demonstrably severe depression which manifested itself . . . as a psychotic, self-destructive episode. . . . Resignation in lieu of court-martial eliminates all of the benefits of medical support this officer deserves after 7 years of credible and honorable service."

Rowe overruled Schoomaker. He agreed to accept Whiteside's resignation with a "general under honorable conditions" discharge that would still deprive her of most benefits, according to her pro bono civilian attorney, Matthew J. MacLean.

But then, from her battalion commander in Iraq, Whiteside learned that an investigation there had concluded that there was "insufficient evidence for any criminal action to be taken against" her. Furthermore, it had found a hostile command climate and recommended that the officer who had been her nemesis be removed from his position and "given a letter of reprimand for gender bias in assignments and use of intimidation, manipulation and hostility towards soldiers."

With this news, Whiteside asked that her letter of resignation be withdrawn. She would fight the charges.

In an e-mail exchange, the prosecutor, Wolfe, told MacLean that even if Whiteside won in court she would probably end up stigmatized and in a mental institution, just like John Hinckley, the man who shot President Ronald Reagan.

Wolfe suggested that the military court might not buy the mental illness defense. "Who doesn't find psycho-babble unclear . . . how many people out there believe that insanity should never be a defense, that it is just, as he said, an 'excuse.' "

Whiteside lived with other outpatient soldiers in a building on the grounds of Walter Reed. She kept her quarters neat and orderly. As her preliminary hearing approached, she often went to bed at 8 p.m. to sleep away her impending reality. She attended morning formation and medical appointments. On weekends she hung out with her clique from Ward 54, "my little posse of crazy soldiers," as Whiteside called them.

She still had the innate ability to motivate soldiers. To pass time one recent Sunday, Whiteside drove a small group of outpatients to go bowling at the National Naval Medical Center in Bethesda. "You can do better," she told a young private who was a terrible bowler. "We'll pool our energy together and get a strike."

Whiteside also offered encouragement over the phone to her friend Sammantha Owen-Ewing, the soldier she befriended on Ward 54 who had been abruptly dismissed from the Army. Sammantha was waiting to see if she could receive her care from the Department of Veterans Affairs.

Whiteside feared the same fate.

At the hearing, the testimony focused on Whiteside's state of mind at the time of her shooting. The hearing officer would have seven days to make a recommendation on whether to dismiss the charges, offer a lesser punishment or go to court-martial. The final decision will be Rowe's.

A psychiatrist who performed Whiteside's sanity board evaluation testified that he found the lieutenant insane at the time of the shooting. One of the doctors said that Whiteside had a "severe mental disease or affect" and that she "did not appreciate the nature and quality of her actions." Brandt, chief of Behavioral Health Services in Walter Reed's Department of Psychiatry, testified that Whiteside was "grappling with holding on to her sanity," adding: "She was right on the edge, and she fell off."

Wolfe made his argument for a court-martial. "These are very serious charges," he said. "The more serious the crime, the higher level it must be disposed of. . . . The government's position is it should be a court-martial."

When the hearing ended, Whiteside walked outside into the cold. Her phone buzzed with a text message from the husband of her friend Sammantha, asking Whiteside to call right away.

Sammantha had hung herself the night before.

On Friday, Whiteside and her father flew to Utah for the funeral. Yesterday, after a service at a small Mormon church, Sammantha Owen-Ewing was buried.

Grief-stricken by the death of her friend and bitter at the Army, Whiteside awaits the Army's decision this week.